Association between oxidative balance score and sarcopenia in older adults

BACKGROUND: Sarcopenia, a prevalent muscle disorder in the older adults, is
characterized by accelerated loss of muscle mass and function, contributing to
increased risks of falls, functional decline, and mortality. The relationship
between dietary oxidative balance score (DOBS) and sarcopenia, however, remains
unclear.
METHODS: We conducted a cross-sectional analysis of the National Health and
Nutritional Examination Survey (NHANES) 2011-2018 cohort, which included 8,240
participants, aged 47.2 ± 17.6 years (48.6% male, 51.4% female). The
participants were selected from geographic locations across all 50 states and
the District of Columbia, using a stratified, multistage probability sampling
design to collect health and nutritional data representative of the civilian,
non-institutionalized U.S.
POPULATION: We employed the generalized additive model to identify potential
non-linear relationships and utilized the two-piecewise linear regression model
to investigate the association between DOBS and sarcopenia in American adults.
RESULTS: Participants were categorized into quartiles based on their DOBS, and
sarcopenia was diagnosed in 702 individuals (8.5%). In the unadjusted model,
DOBS exhibited a significant negative correlation with sarcopenia (β = 0.97, 95%
Confidence Interval (CI): 0.96 to 0.99, P < 0.001). This association remained
consistent in the model with minimal adjustment for age and gender (β = 0.97,
95% CI: 0.96 to 0.98, P < 0.001) and in the fully adjusted model including
additional covariates (β = 0.97, 95% CI: 0.96 to 0.99, P < 0.001). After
adjusting for potential confounders, we identified a non-linear association DOBS
and sarcopenia, with an inflection point at 23. The effect sizes and CIs to the
left and right of the inflection point were 1.62 (95% CI: 1.09 to 2.41,
P = 0.016) and 0.97 (95% CI: 0.95 to 0.98, P < 0.001), respectively. Subgroup
analyses confirmed the stability of this relationship across various demographic
and health-related variables.
CONCLUSIONS: This research provides new insights into the association between
diet quality, as assessed by DOBS, and sarcopenia, reinforcing the critical role
of a balanced, antioxidant-rich diet in adult muscle.

DOI: 10.1186/s12986-025-00894-4
PMCID: PMC11752774
PMID: 39844270

Conflict of interest statement: Declarations. Ethics approval and consent to
participate: All data for this study were obtained from the NHANES database, and
the National Center for Health Statistics (NCHS) Ethics Review Board approved
the NHANES, approval no. #2005- 06, # 2011- 17. This study was conducted
according to the guidelines laid down in the Declaration of Helsinki, and all
procedures involving research study participants were approved by the Research
Ethics Review Board of NCHS. Written informed consent was obtained from all
subjects. Competing interests: The authors declare no competing interests.
Conflict of interest: All the authors declare that they have no competing
interests.